What to expect with Early (Phase 1) Orthodontic Treatment

In the last blog, I addressed why early treatment (often called Phase 1 treatment) may be recommended, and the conditions that often require early intervention. As a summary, early treatment has been recommended by Dr. Rejman only if a window of opportunity will be missed (due to age and skeletal growth patterns) that will negatively affect a child’s facial structure, bite, esthetics, or periodontal support (tooth stability). Orthodontists undergo years of study focused on craniofacial growth and development, and there is considerable variation in age regarding dental and skeletal maturity between children. Dr. Rejman will inform you when we can best take advantage of this growth, and will let you know when the optimal time is to begin treatment. Orthodontic treatment and a child’s growth
should complement each other if it is timed properly.

If early treatment has been recommended for your child, here is what to expect:

• Because early treatment occurs during the mixed dentition (when both “baby” and “adult” teeth are present), treatment does not involve a full set of braces. We often use a limited number of braces to achieve the desired correction, in conjunction with other devices such as an expander and appliances designed to improve the relationship the child’s upper and lower jaws. It is sometimes advantageous to have several baby teeth removed if there is a severe issue with spacing or improper tooth eruption.

• Because Phase 1 is problem focused, we like to be as efficient as possible, and remove the appliances and limited braces once the problem has been addressed. Phase 1 treatment can be as short as 6 months (for dental based interceptive issues), to more than a year for more difficult skeletal issues (such as underbites).

• Retainers will be fit to maintain the correction that has been achieved while we wait for the permanent teeth to erupt. We use a number of different retainers to maintain the correction of different problems. The nice thing for kids is that retainers are usually only worn at night while they are sleeping.

• Often retainers will stop fitting correctly as more permanent teeth continue to erupt, and retainers after Phase 1 are relatively temporary for this reason. Dr. Dan checks the patient’s bite every four to six months during this period and will let you know when it is time to stop wearing this retainer (this is usually when they are ready for the full set of braces).

• Early treatment is very problem focused, and Phase 1 is only meant to address a specific concern that needs immediate attention, not align the entire dentition. We use the name “Phase 1”, because it implies that there will usually be a “Phase 2” when a full set of braces is used to align the full set of adult teeth when they have erupted. This usually occurs between the ages of 10-14 years old (there is considerable variation in physical and dental maturity and development in children!).
I hope this answers many of the questions that you may have regarding your child’s development, and early treatment if it has been recommended.

Dr. Dan Rejman is a Board Certified Orthodontic Specialist, and is the owner of Meadows Orthodontics in Castle Rock, Colorado.